Obesity & Bariatric Surgery

Mini Gastric Bypass
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The Mini Gastric Bypass (MGB) is a modified version of classical Roux-en-Y gastric bypass. It was developed by Dr Robert Rutledge in the 1990s. In the MGB, stomach is first divided into a small, narrow upper pouch and a large lower pouch. The small, narrow upper gastric pouch is created along lesser curvature of stomach excluding the antrum and the fundus. Then it is anastomosed with small bowel about 180-200cm from the beginning of jejunum. Thus the large lower stomach pouch and proximal intestines is excluded from the digestive process.

MGB is a simpler, safer surgery compared to Roux-en-Y gastric bypass with low risk but effective in getting and maintaining significant weight loss and excellent resolution of co-morbidities. It is also reversible. It is done laparoscopically. MGB is both restrictive and malabsorptive procedure. This procedure reduces the size of the stomach, restricting the amount of food intake. It also reduces food absorption by bypassing proximal intestine.

Advantages of MGB compared to Roux-en-Y gastric bypass

•             Technically simpler and relatively shorter operating time.

•             Only one anastomosis required

•             Lesser re-routing and manipulation of intestines

•             Lesser complication rates, hence relatively safer

•             Similar results regarding weight loss and resolution of co-morbidities.

 

Disadvantages of MGB

•             Acid reflux can be troublesome in some patients.

•             Dumping syndrome.

•             More data needed on long-term efficacy.

•             Life long nutritional supplementation required.

 

Post-operative recovery

MGB patients have recovery similar to other bariatric procedures. Post-operative pain, hospital stay, diet, time required to return to work etc. are similar to Sleeve gastrectomy and Roux-en-Y gastric bypass.

Complications

Minor complications include wound infections, port site hernias etc., whereas, major complications can be internal bleeding, staple line leaks, stricture, pulmonary embolism etc.